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17A-138 (5) BP-2023-0425 225 CHESTNUT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17A-138-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2023-0425 PERMISSION IS HEREBY GRANTED TO: Project# KITCHEN RENO 2023 Contractor: License: Est. Cost: 20700 Const.Class: Exp.Date: KOLYSKO SEWERYN &KATHERINE S CHOLAKS- Use Group: Owner: KOLYSKO Lot Size (sq.ft.) KOLYSKO SEWERYN & KATHERINE S CHOLAKS- Zoning: URA Applicant: KOLYSKO Applicant Address Phone: Insurance: 225 CHESTNUT ST FLORENCE, MA 01062 ISSUED ON: 04/10/2023 TO PERFORM THE FOLLOWING WORK: KITCHEN RENO POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: it I Fees Paid: $135.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner . ♦` tl. is � mi r,. . The Commonwealth of Massachusetts `— Board of Building Regulations and Standards FOR Massachusetts State Building Code, 780 CMR APR 1 0 2023 MUNICIPALITY USE Building Permit Application To Construct, Repair,Renovate Or Demolish a Revised Mar 2011 One- or Two Family Dwelling" ;,(-,,,eun Dlr:r=,IN P4C:cleil5 This Section For Official Use Only i' ''r .,"'�- Building Permit Number: cO- }- —41?-.5-- Date Applied: 'N w . , Ill a ; 3 Building Official(Print Name) Signature f D e SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 225 Chestnut St.Florence,MA 01062 J 7 A PA A - 132 - O o) 1.1 a Is this an accepted street?yes x no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: VRA rts;dc.n4 L,fL 04t a.ut.s 56. .2.5 -4.F Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided ;,0 I S V.43 1.6 Water Supply: (M.G.L,c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: \' Zone: -- Outside Flo�d.Zone? Public® Private❑ Check if ye� Municipal On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Seweryn Kolysko,Katherine Cholakis-Kolysko Florence,MA 01062 Name(Print) City, State,ZIP 225 Chestnut St. 623-202-8243 skolysko@gmail.com No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK(check all that apply) New Construction 0 Existing Building la Owner-Occupied la Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units I Other 0 Specify: Brief Description of Proposed Work':Kitchen renovation within the existing footprint.Open walls and ceiling to inspect for structural integrity and insulate.Add fire blocking.Update plumbing and electrical to code.Close walls.Install new cabinets of similar size and location to existing cabinets. There will be no changes to appliance types and/or locations.All existing appliances will be re-installed in their current locations. See additional page for a more thorough description of project scope. SECTION 4: ESTIMATED CONSTRUCTION COSTS Estimated Costs: Item Official Use Only 1. t $ 17 000 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ 15o 0 ❑ Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ ) O 0 2. Other Fees: $ 4. Mechanical (HVAC) $ — o List: 5.Mechanical (Fire c`-'Suppression) $ 0 Total All Fees: $ ) �. Check No. Check Amount: 6. Total Project Cost: $ a_O, 700 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name No.and Street Email address City/Town, State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes 0 No .0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize N/A to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowled a and understanding. jO f471--) caner s or Authorized Agent's Name(Electronic Signature) Anan. '111111=1116 NOTES: 1. An Owner who obtains a building permit to do his/her own work,or ati owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) t800 (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) 1600 Habitable room count 5 Number of fireplaces 0 Number of bedrooms 3 Number of bathrooms 1 Number of half/baths 0 Type of heating system gas,steam Number of decks/porches 2 Type of cooling system none Enclosed I (front porch) open 1 3. "Total Project Square Footage"may be substituted for"Total Project Cost" •-- The Commonwealth of Massachusetts =t- Department of Industrial Accidents -21FI Congress Street,Suite 100 r ,l Fn Boston, MA 0 2114-201' wwii:tnass.gov/dirt •- Workers'Compensation Insurance Alrtdasit:Builders+Contraetors(Eketr'iclansfPlumbers. T{)BE t'lt.lE:D 11'I°1•H THE:I'ER11I1l'I!ri(:Ali't'HORIT1'. Annlicaut Inforittation Please Print Leiiblh Name I Bus iness:Orgnniz:tti:n Indic itittril►: Seweryn Kolysko,Katherine Cholakis-Kolysko 225 Chestnut St. Address: City'r Statel'Zip: Florence,MA 01062 Phone ??' 623-202-8243 Air yea an engrkoyer?Cheek the*pi islwbti boot: Type of project(required): I.©1 am a employer with _employees(full an&or part.titrte).` 7. 0 New construction 2.1 I am a Gale'stiprieiot ur pnrinership and here to employees working for me in S, Q Remodeling any capacity-No wuritarx'comp.insurance required.! 9. [ Demolition 101 am u luatteom na doing all work rrry d1.'No unrkers'runic-imttrarrot inquired.] l(I 0 Building addition. Vlain a hurtieow et and will tee luring ooa,sracturs w i?0Oduet all work on errs property: I will ensure that all eycuitraeturs either have wVrtltets'emnpetraation nrsuranee or aft sole 1 t Electrical repairs or additions prupnetun with w e=mplrtyeet: 12.0 Plumbing repairs or additions 5 I unr u irrrueral contractor aril 1 hto.e hired the rwb-nominee air i Bated un the"tinkled sheet. Them:i.ub-contractors have employees and have workers'camp.insurance.; !30 Root repairs ei.❑We,ute a cusp iratinn and it,,i&er i have exercised their right ut exemption per MIL c. 14.Q Other kitchen remodel 152,§I(4),and we have nu employees.No woken'eump.iniurarrce.tegithe .} 'Any applicant that eheeks box a I.taunt also fill out the sieiisom below showing their wuricers'compensation- pitic uslcmnutrrwl t N arirowt:ta who submit this affsdaaat iiubeatirsy they art doing all work and then hue outside a ntraetucs must submit a new affidavit indicating such. !Glom aeiura that cheek this box must utuehed an additional sheet shoving the name of dig sub-contractors and state whether ur not those entities have employed. If the sub•CUnttaetrvs list+....-mpluyeeS,they nu Nt ptue ide their workers-comp.peiliti}'number 1 am an employer that is providing workers'compensation insurance file my employees. Below is the policy and Job site information. Insurance Company Name:Policy 4 or Self ins. Lac.#: Expiration Date: Job Site Address: City/State:'Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL 152. §25A is a criminal viulatioo punishable by a fine up to SI 500.00 and or one-year iipprisonment.as well as civil penalties in the form of a STOP WORK ORDER and a lute of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby(eras tinder the pain.% unit penultiri ref pedrrry that the information provided abort'is true and correct, Signature: S Dater. 0`1 I to /2-0 023 Phone' : 6 61.3- Zfl ) Official use only. Do not write in rlri,A area, err be crrnipleted by city or ier►n official city or Town: Permit/License i Issuing Authority(circle one): I. Board of Health 2.Building Department 3.('ityrTown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone t: City of Northampton Massachusetts ••, e • • '4, • ' • DEPARTMENT OF BUILDING INSPECTIONS y '�' x 212 Main Street • Municipal Building b~ Northampton, MA 01060 JJIyY 3,O° 8 HOMEOWNERS'EXEMPTION ELIGIBII ITY AFFIDAVIT SEW£2Y 4 Ko Ls( S JCo oq L i 4 I ns r 0 I, (insert full legal name), born_ (insert month, day,year),hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I a seeking the aforementioned homeowners' exemption, does not involve the field erection of manufacture buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns a parcel of land on which he/she ides or intends to reside, on which there is, or is intended to be, a one-or two-family dw lling, attached or detached structures accessory to such use and/or farm structures.A person 1 ho constructs more than one home in a two-year period shall not be considered a home owner 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any, project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection With the aforementioned project or work on my parcel,I acknowledge that I am required to and will act as he supervisor for said project or work. Signed under the pains and penalties of perjury on this I I day of AP^IL_ , 2023, (Signature) City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building vp, �► Northampton, MA 01060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: 4 G �)`''� e GJ�n 3'� �• S-fi �``,-h^�fiO''` I\CJ1 t r.. '�y.. % Mf1 The debris will be transported by: Name of Hauler: 61 rY%•1 � Signature of Applicant: S Ili '' 3 - �� �, �--F� Date: HOME RENOVATION ADDENDUM WITH PROJECT SCOPE Address: 225 Chestnut St., Florence, MA 01062 Dwelling type: Residential,single family,owner occupied Home owner: Seweryn (Sev) Kolysko SCOPE OF PROJECT Kitchen renovation within the existing kitchen footprint without changes to kitchen layout and/or appliance layout. No changes to wall location and/or structure. Open walls and ceiling to add fire blocking and insulation. Install new cabinets of similar size and layout to the existing cabinets. Reinstall appliances. Anticipated start date:April 28, 2023 STEPS: 1. Remove cabinets and open existing lath and plaster walls. 2. Inspect structural components of framing. 3. Rough in plumbing and electrical work: a. Plumbing:Tim Lamontagne,will submit permit application separately to plumbing inspector. b. Electrical:John Bates,will submit permit application separately to electrical inspector. 4. Insulate walls and add fire blocking. 5. Inspections. 6. Close walls with drywall. 7. Install new flooring on existing subfloor. 8. Install cabinets(similar size and location to that of existing cabinets). 9. Re-install electrical and plumbing fixtures(electrician, plumber). 10. Final inspections. S , r,„,e_tioc__„, 11 „ Id__,e3